Provider Demographics
NPI:1558549998
Name:PATTERSON, APRIL L (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:APRIL
Middle Name:L
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:866 EDENRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-3127
Mailing Address - Country:US
Mailing Address - Phone:330-518-9579
Mailing Address - Fax:
Practice Address - Street 1:866 EDENRIDGE DR
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-3127
Practice Address - Country:US
Practice Address - Phone:330-518-9579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-07
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN306243367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH8243902OtherMEDICARE PTAN
OHP00728515OtherMEDICARE RAILROAD
OH2912781Medicaid
OH000000594658OtherANTHEM